Too many experts spoil the science

Writing in this week's British Medical Journal (BMJ), Canadian-based researcher, David Sackett, said that he would "never again lecture, write, or referee anything to do with evidence based clinical practice".

Sackett is not doing this because he has ceased to believe in evidence based clinical practice but, as the BMJ comments, because he is worried about the power of experts in stifling new ideas and wants the retirement of experts to be made compulsory.

Sackett claims that the prestige of experts (including himself) gives their opinions far greater persuasive power than they deserve on scientific grounds alone.

"Whether through deference, fear, or respect, others tend not to challenge them, and progress towards the truth is impaired in the presence of an expert," he writes.

He also argues that expert bias against new ideas operates during the review of grant applications and manuscripts.

"Reviewers face the unavoidable temptation to accept or reject new evidence and ideas, not on the basis of scientific merit, but on the extent to which they agree or disagree with the public positions taken by experts on these matters."

David Sackett in a non-expert mode

This is Sackett's second retirement from expertise. In 1983 he was an expert in compliance with therapeutic regimens. He wrote a paper calling for the compulsory retirement of experts and never again lectured, wrote, or refereed anything to do with compliance.

Sackett began studying evidence based medicine, in which he subsequently also became an expert. As before, he has decided to "get out of the way of the young people now entering this field" calling on fellow experts to do the same.

"To be sure, many of them are sucked into chairs, deanships, vice presidencies, and other black holes in which they are unlikely to influence the progress of science or anything else for that matter," he writes.

"Surely a lot more people could retire from their fields and turn their intelligence, imagination, and methodological acumen to new problem areas where, having shed most of their prestige and with no prior personal pronouncements to defend, they could enjoy the liberty to argue new evidence and ideas on the latter's merits."

Support for SackettThe BMJ also challenges its many expert readers "either to renounce their expertness or to produce compelling arguments, preferably evidence based, in favour of experts."

David Sackett in another non-expert mode

Australian researcher Chris Silagy, who also has expertise in the area of evidence-based medicine, agrees with Sackett's sentiments, however urges some caution.

"Sackett's comments are provocative, as is his style. And as with all provocative statements, there is more than a grain of truth in them," he told the ABC. "No matter what position you're in, any expert must be constantly prepared to question, keep an open mind and admit uncertainty."

"The art of the expert now is to synthesise and critically evaluate knowledge, to interpret rather than pronounce certainties."

However, Silagy warned against a too literal interpretation of Sackett's call for experts to move fields so as to keep intellectually challenged.

"Sackett himself acknowledges that evidence based practice involves combining knowledge with intuition, wisdom and experience - which is only accumulated over time," he says.